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HIV testing: India ranked best, Russia worst

The Lancet study compared data from several clinics in each country to calculate the cost-effectiveness and quality of services provided

New Delhi: India topped the list of five mid-income countries that provide free HIV testing and counselling to people, reported the scientific journal ‘The Lancet’. The unexpected pat on the back came after a comparison of testing and counselling facilities in India, Russia, Mexico, Uganda and South Africa that showed India’s was not only the cheapest but also the most cost-effective. Russia did the worst.

The Lancet study compared data from several clinics in each country to calculate the cost-effectiveness and quality of services provided. "India and Russia represent the two extremes in terms of implementation performance, with the quality of services being similar in almost all centers surveyed in India. The difference between quality in different clinics was the highest in Russia," said lead author Dr. Stefano M. Bertozzi from the National Institute of Public Health, presenting the data at the XVII International AIDS Conference on Tuesday.

India’s programme, run by the National AIDS Control Organisation, is also the most cost effective, costing the government US$ 3 (Rs 120) per person. The cost was as high as US$ 1,000 in some centres in Russia.

One reason for cost being down in India was the number of people counselled and tested, with a study showing that doubling the numbers reduced the average cost by 50 per cent in India, "We may have the volumes, but that too is because people have increased awareness about the disease and more and more are coming forward to get tested. You must remember that the testing is purely voluntary and people can refuse if they so wish," says Suresh Mohammed, national programme officer, National AIDS Control Organisation.

There are 2.47 million people living with HIV in India, with almost 1.6 lakh getting free treatment under the government programme. The cost to government is Rs 550 per patient per year.

Dolling up sex education

Former US policewoman Marcia Morgan uses a unique sex education tool that crosses all language barriers: dolls with sexual body parts. “Anatomical dolls help children de-personalise and share their own perceptions about sexual behaviours, including abuse,” says Morgan, tUS-based consultant in criminal justice and social issues.

Morgan developed the dolls 30 years ago to help sexually abused children describe what happened to them. These dolls are currently used for sex education not just in the US but also in Mozambique, where role-playing helps children with no education learn about sexual body parts, pregnancy prevention, preventing sexually-transmitted diseases and how to wear a condom.

“Apart from genetalia, these dolls have mouths and tongues and come with clothes and underclothes. They come in shades of white, light brown and dark brown and can be dressed in clothes appropriate to the area where there are being used," says Morgan. Given the opposition to sex education in India, these dolls are not likely to be seen in a sari or kurta soon.